Thomas R Prostko (NPI# 1417928243, PAC ID# 9032187380) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GASTROENTEROLOGY.
| Nation Provider ID (NPI) | 1417928243 |
| PAC ID by PECOS | 9032187380 |
| Professional Enrollment ID | I20080925000532 |
| Full Name | Thomas R Prostko |
| Organization Legal Name | CANNON MEMORIAL HOSPITAL |
| Address |
123 W G Acker Dr Pickens SC 29671-2739 |
| Phone Number | 8648784791 |
| Gender | M |
| Medical School | TUFTS UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1983 |
| Primary Specialty | GASTROENTEROLOGY |
| Secondary Specialties | INTERNAL MEDICINE |
| Group Practice PAC ID | 8123930666 |
| Number of Group Practice Members | 22 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 420011 | CANNON MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 123 W G Acker Dr, Pickens, SC 29671-2739 | 8648784791 | CANNON MEMORIAL HOSPITAL |
| Organization Legal Name | CANNON MEMORIAL HOSPITAL |
| Physicians | 19 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lori K Ellenburg | Nurse Practitioner | Cannon Memorial Hospital | 123 Wg Acker Dr, Suite B, Pickens, SC 29671-2739 |
| Augusta B Hall | Nurse Practitioner | Cannon Memorial Hospital | 105 Liberty Blvd, Liberty, SC 29657-1641 |
| Yashbir S Rana | Emergency Medicine | Cannon Memorial Hospital | 123 W G Acker Dr, Pickens, SC 29671-2739 |
| Glenda G Snyder | Nurse Practitioner | Cannon Memorial Hospital | 111 W Roper Rd, Easley, SC 29640-8805 |
| Peter C Schriver | General Surgery | Cannon Memorial Hospital | 885 Tiger Blvd, Suite A, Clemson, SC 29631-1480 |
| Byron P Marsh | Orthopedic Surgery | Cannon Memorial Hospital | 123 Wg Acker Dr, Suite C, Pickens, SC 29671-2739 |
| Trang D Lusk | Nurse Practitioner | Cannon Memorial Hospital | 111 W Roper Rd, Easley, SC 29640-8805 |
| Heather Renee Turner | Nurse Practitioner | Cannon Memorial Hospital | 111 W Roper Rd, Easley, SC 29640-8805 |
| Travis W Davis | Family Medicine | Cannon Memorial Hospital | 105 Liberty Blvd, Liberty, SC 29657-1641 |
| John Robert Randolph | Family Medicine | Cannon Memorial Hospital | 105 Liberty Blvd, Liberty, SC 29657-1641 |
| Street Address |
123 W G ACKER DR |
| City | PICKENS |
| State | SC |
| Zip | 29671-2739 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Yashbir S Rana | Emergency Medicine | Cannon Memorial Hospital | 123 W G Acker Dr, Pickens, SC 29671-2739 |
| Michael L Dillard | Emergency Medicine | Cannon Memorial Hospital | 123 W G Acker Dr, Pickens, SC 29671-2739 |
| Robert Goodwin Person | Family Medicine | Cannon Memorial Hospital | 123 W G Acker Dr, Pickens, SC 29671-2739 |
| Peter C Woods | Certified Registered Nurse Anesthetist (crna) | Cannon Memorial Hospital | 123 W G Acker Dr, Pickens, SC 29671-2739 |
| Robert M Richey Sr. | Internal Medicine | Cannon Memorial Hospital | 123 W G Acker Dr, Pickens, SC 29671-2739 |
| Glenn G Williams | Emergency Medicine | Cannon Memorial Hospital | 123 W G Acker Dr, Pickens, SC 29671-2739 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Chase E Bentley | Chiropractic | 114 Pumpkintown Hwy, Pickens, SC 29671-2023 | |
| Brian R Dooley | Chiropractic | 209 E Main St, Pickens, SC 29671-2314 | |
| William W Spearman | Optometry | Myeyedr Optometry of South Carolina, LLC | 306 E Main St, Pickens, SC 29671-2385 |
| Benjamin T Avritt | Chiropractic | 430 Hampton Ave, Pickens, SC 29671-2608 | |
| Lori K Ellenburg | Nurse Practitioner | Cannon Memorial Hospital | 123 Wg Acker Dr, Suite B, Pickens, SC 29671-2739 |
| Byron P Marsh | Orthopedic Surgery | Cannon Memorial Hospital | 123 Wg Acker Dr, Suite C, Pickens, SC 29671-2739 |
| Samuel C Venturella | Diagnostic Radiology | Diagnostic Radiology of Anderson, P.a. | 123 Wg Acker Dr, Pickens, SC 29671-2739 |
| James Mahanes | General Surgery | Cannon Memorial Hospital | 123 Wg Acker Dr, Suite D, Pickens, SC 29671-2739 |
| City | PICKENS |
| Zip Code | 29671 |
| Specialty | GASTROENTEROLOGY |
| City + Specialty | PICKENS + GASTROENTEROLOGY |
Please comment or provide details below to improve the information on Thomas R Prostko.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.